Blood flow distribution in a large series of patients having the Fontan operation: a cardiac magnetic resonance velocity mapping study.
Blood flow distribution in a large series of patients having the Fontan operation: a cardiac magnetic resonance velocity mapping study.
复制标题
DOI：
10.1016/j.jtcvs.2008.11.062
复制
发表时间：
2009-07
影响因子：
6
通讯作者：
Fogel, Mark A.
中科院分区：
文献类型：
--
作者：
Whitehead, Kevin K.;Sundareswaran, Kartik S.;Parks, W. James;Harris, Matthew A.;Yoganathan, Ajit P.;Fogel, Mark A.
确定Fontan患者（有或无双侧上级静脉）腔静脉连接处的血流分布。目前还没有建立Fontan患者的血流分布的大型系列，这将是日常临床使用的重要资源，并可能影响未来的手术重建。我们研究了105例Fontan患者（年龄2 - 24岁），通过平面相位对比速度图来确定下腔静脉和上级腔静脉以及左肺动脉和右肺动脉的流速。上级腔静脉吻合型包括双向Glenns 40例（其中15例为双侧）和半Fontans 53例; Fontan型包括房内挡板69例，心外管道28例，心房连接4例。总腔静脉流量为2.9±1.0 l/min/m2，下腔静脉占59%± 15%。肺动脉总流量为2.5±0.8 l/min/m2，在统计学上小于腔静脉流量，并且无法通过存在开窗来解释。右肺动脉的贡献率（55%±13%）显著高于左肺动脉。在双侧上级腔静脉的患者中，右腔静脉占血流的52%±14%，肺血流分流没有差异（50%±16%向右）。年龄和体表面积与下腔静脉贡献百分比相关（r分别为0.60和0.74）。上级腔静脉吻合术和Fontan型对肺血流分离无明显影响。总Fontan心脏指数为2.9 l/min/m2，肺血流分流正常（55%流向右肺）。下腔静脉对总流量的贡献随体表面积和年龄的增加而增加，与健康儿童的数据一致。
To determine flow distribution in the cavopulmonary connections of Fontan patients with and without bilateral superior vena cavae. No large series exists that establishes the flow distributions in Fontan patients, which would be an important resource for everyday clinical use and may impact future surgical reconstruction. We studied 105 Fontan patients (ages 2 - 24 years) with through-plane phase contrast velocity mapping to determine flow rates in the inferior and superior vena cava, and left and right pulmonary arteries. Superior caval anastomosis type included 40 bidirectional Glenns (of which 15 were bilateral) and 53 hemi-Fontans, while Fontan type included 69 intra-atrial baffles, 28 extracardiac conduits, and 4 atriopulmonary connections. Total caval flow was 2.9±1.0 l/min/m2, with an inferior vena cava contribution of 59%±15%. Total pulmonary flow was 2.5±0.8 l/min/m2, statistically less than caval flow and not explained by fenestration presence. The right pulmonary artery contribution (55%±13%) was, statistically greater than the left. In patients with bilateral superior cavae, the right cava accounted for 52%±14% of the flow, with no difference in pulmonary flow splits (50%±16% to the right). Age and body surface area correlated with percent inferior caval contribution (r = 0.60 and 0.74 respectively). Superior vena cava anastomosis and Fontan type did not significantly affect pulmonary flow splits. Total Fontan cardiac index was 2.9 l/min/m2, with normal pulmonary flow splits (55% to right lung). Inferior vena cava contribution to total flow increases with body surface area and age, consistent with data from healthy children.
登录
查看更多内容
影响因子：
37.8
作者：
BENSHACHAR, G;FUHRMAN, BP;LOCK, JE
通讯作者：
LOCK, JE
影响因子：
5.7
作者：
Pedersen, EM;Stenbog, EV;Hjortdal, VE
通讯作者：
Hjortdal, VE
影响因子：
37.8
作者：
Fogel, MA;Weinberg, PM;Haselgrove, J
通讯作者：
Haselgrove, J
影响因子：
37.8
作者：
SALIM, MA;DISESSA, TG;ALPERT, BS
通讯作者：
ALPERT, BS
影响因子：
37.8
作者：
Beerbaum, P;Körperich, H;Meyer, H
通讯作者：
Meyer, H